Abstract
Purpose: To compare the success and complication rates of low target pressure trabeculectomy (LTT) and conventional trabeculectomy (CT). Methods: A retrospective study was conducted with consecutive patients undergoing trabeculectomy. Twelve eyes of 12 patients underwent LTT, and 17 eyes of 17 patients underwent CT. Surgical success was defined as meeting each target intraocular pressure (IOP) without additional medication or further glaucoma surgery. A Kaplan-Meier survival analysis was used to estimate survival rate. Incidences of surgical complications were also assessed. Results: The median postoperative IOP 2 years after surgery were 10.0 mmHg (interquartile range [IQR] 8.5 - 12.0 mmHg) in the LTT group and 16.0 mmHg (IQR, 14.0 - 18.5 mmHg) in the CT group (P = 0.000). Estimated survival rates for patients who underwent the two types of trabeculectomy were significantly different with all IOP criteria of 10, 12 and 14 mmHg (P
Highlights
Glaucoma is an optic nerve disease and a leading cause of irreversible blindness
Surgical success was defined as meeting each target intraocular pressure (IOP) without additional medication or further glaucoma surgery
The Institutional Review Board (IRB)/Ethics Commitee approval was obtained for this retrospective study, and informed consent was obtained from all participants before surgery
Summary
Lowering of IOP is the most effective treatment to prevent glaucoma progression [1]. Trabeculectomy is the most popular surgical procedure for lowering IOP in patients with glaucoma refractory to medical and laser treatment, primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) [2]. Maintenance of adequate aqueous outflow through the fistula is essential to prevent bleb failure. The size of the scleral flap and internal sclerostomy are the most important factors determining the amount of aqueous flow as well as the thickness of the scleral flap. More aqueous outflow results in a lower IOP, over filtration of the aqueous humor leads to hypotony and complications including maculopathy and choroidal detachment. It is important to make the scleral flap sufficiently large to cover the inner sclerotomy to prevent over filtration. Most surgeons create a 3 - 4-mm-wide half-layer scleral flap and a 1.0 - 1.5-mm deep sclerostomy during the surgery [4] [5] [6] [7] [8]
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